系统性红斑狼疮患者糖皮质激素联合免疫抑制剂治疗前后外周血NK细胞和受体表达变化及其治疗作用机制  

Changes of NK cells and its receptors expressions in peripheral blood of patients with systematic lupus erythematosus before and after treatment of glucocorticoid combined with immunodepressant

作　　者：冯莉[1] 赵令[1] 马宁[1] 姜振宇[1] 

机构地区：[1]吉林大学第一医院风湿科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2014年第1期159-163,共5页Journal of Jilin University：Medicine Edition

基　　金：吉林省长春市科技局科研基金资助课题(201212)

摘　　要：目的:探讨经糖皮质激素联合免疫抑制剂干扰素γ(IFN-γ)治疗前后系统性红斑狼疮(SLE)患者外周血中自然杀伤细胞(CD3-CD56+NK细胞)及其激活性、抑制性受体表达的变化,阐明其治疗SLE的作用机制。方法:选取26例SLE患者和16例健康对照者,采用流式细胞术检测2组受试者治疗前、治疗4和12周后外周血CD3-CD56+NK细胞比率及其激活性受体和抑制性受体表达率。结果:与健康对照组比较,治疗前SLE患者CD3-CD56+NK细胞比率明显降低(P<0.05),其激活性受体NKG2C+、NKP30+和NKP46+的表达率均明显增高(P<0.05),抑制性受体KIR2DL3+、KIR3DL1+和NKG2A+的表达率均明显降低(P<0.05),IFN-γ+CD3-CD56+NK细胞比率明显增高(P<0.001)。与治疗前比较,治疗4和12周后SLE患者CD3-CD56+NK细胞比率均明显增高(P<0.05);治疗4周后SLE患者CD3-CD56+NK细胞激活性受体NKG2C+、NKP30+和NKP46+的表达率均明显降低(P<0.05),治疗12周后上述受体表达率均进一步降低(P<0.05)。治疗4周后SLE患者CD3-CD56+NK细胞抑制性受体KIR2DL3+、KIR3DL1+和NKG2A+的表达率较治疗前均明显增高(P<0.05),治疗12周后CD3-CD56+NK细胞KIR3DL1+、CD158a+、CD158b+和NKG2A+的表达率较治疗前均明显增高(P<0.05)。与治疗前比较,治疗4和12周后SLE患者IFN-γ+CD3-CD56+NK细胞比率均明显降低(P<0.001)。结论:NK细胞及其受体的变化可能与SLE的发病有关,糖皮质激素联合免疫抑制剂可能通过调节NK细胞及其受体的变化发挥治疗作用。Objective To explore the changes of NK cells and the expression leVels of their activated and inhibitory receptors in peripheral blood of the patients with systematic lupus erythematosus （SLE） before and after treatment of glucocorticoid combined with immunodepressant, and to clarify its action mechanism on SLE. Methods 26 patients with new onset SLE and 16 healthy controls were selected. The expression levels of NK cells, their activated and inhibitory receptors in peripheral blood in two groups were detected before treatment,4 and 12 weeks after treatment by flow cytometry. Results Compared with control group, the ratio of CD3- CD56＋ NK cells of the patients with SLE and the expression levels of KIR2DL3＋ , KIR3DL1＋ , NKG2A＋ NK in SLE patients group before treatment were significantly decreased （P%0.05）; the expression levels of NKG2C＋ , NKP30＋ , NKP46＋ , and the ratios of IFN-γ＋ NK cells were significantly increased （P〈0. 001）. Compared with before treatment, the ratios of CD3 CD56＋ NK cells in the patients with SLE 4 and 12 weeks after treatment were significantly increased （P〈0.05） ; the expression levels of NKG2C＋ , NKP30＋ , and NKP46＋ in the patients with SLE 4 weeks after treatment were significantly decreased （P〈 0.05）. 4 weeks after treatment, the expression levels of KIR2DL3＋, KIR3DL1＋, and NKG2A＋ were significantly increased compared with before treatment （P〈0.05）. 12 weeks after treatment, the expression levels of KIR3DL1＋ , CD158a＋ , CD158b＋ , and NKG2A＋ were significantly increased compared with before treatment （P〈0.05）, and the ratios of IFN-γ＋ CD3- CD56＋ NK cells in the patients with SLE 4 and 12 weeks after treatment were significantly decreased compared with before treatment （P〈 0. 001）. Oonclusion The changes of the NK cells and its receptors may be involved in the pathogenesis of SLE. Glueocorticoid combined with immunodepressant may play the therapeutic effect by regulating the expression of NK cells and

关 键 词：系统性红斑狼疮 自然杀伤细胞 干扰素Γ 

分 类 号：R593.241[医药卫生—内科学]